Relato de caso: Insuficiência renal crônica estádio 5 D em paciente com doença renal crônica medicado com varfarina

ResumoIntroduçãoA terapêutica com varfarina pode provocar hematúria grave e lesão renal aguda pela formação de cilindros eritrocitários oclusivos. Estas alterações são sugestivas de uma doença recentemente conhecida como nefropatia relacionada pela varfarina.Caso Clínico:Apresentamos um doente de 74 anos de idade com doença renal crônica estádio 3 A, que progrediu com declínio na taxa de filtração glomerular (TFG) após o início de terapêutica com varfarina devido a um quadro fibrilação atrial. O diagnóstico foi confirmado pela histologia renal, que demonstrou a presença de oclusão tubular por cilindros eritrocitários, achados consistentes com este diagnóstico. O paciente não recuperou a TFG, tendo iniciado terapêutica substitutiva da função renal.Discussão:O objetivo da descrição deste caso clínico é alertar para a complicação associada a este fármaco e reforçar a necessidade de monitorização cuidada da função renal e dos parâmetros de coagulação em doentes tratados com a varfarina. A patogênese e o prognóstico desta entidade também serão discutidos.

Síntese e modificações de derivados heterocíclicos de D-arabinose: potenciais inibidores de glicose-6-fosfato isomerase e de glicosamina-6-fosfato sintase

The synthesis of -5-(D-arabino-1,2,3,4-tetrahydroxybutyl)tetrazole and -2-(D-arabino-1,2,3,4-tetra-acetoxybutyl)-5-methyl-1,3,4-oxadiazole from D-arabinose is described. Attempts at removing the protecting groups of the oxadiazole derivative were unsuccessful, leading to products resulting from the opening of the oxadiazole ring. The unprotected tetrazole derivative was selectively phosphorylated at the primary hydroxyl group with diethylphosphoryl chloride. The resulting 5-[D-arabino-4-(diethylphosphoryloxy)-1,2,3-trihydroxybutyl]tetrazole is a protected form of a potential inhibitor of the enzymes glucose-6-phosphate isomerase and glucosamine synthase.

Strain differentiation of Trichophyton rubrum by random amplification of polymorphic DNA (RAPD)

Trichophyton rubrum is an important cause of dermatomycoses. Molecular strain typing methods have recently been developed to address questions about epidemiology and source of relapse following treatment. This report describes the application of RAPD for molecular strain differentiation of this fungus utilizing the primers 1- (5'-d[GGTGCGGGAA]-3') and 6- (5'-d[CCCGTCAGCA]-3'). A total of five RAPD patterns were observed among 10 strains of T. rubrum, with each of the primers used. We conclude that RAPD analysis using primers 1 and 6 can be used in epidemiological studies.

Spleen cell proliferation during and after skin myiasis by human bot fly Dermatobia hominis

Spleen cells from mice were examined at 5, 10, 15, 20 and 25 days post-infection (dpi) with Dermatobia hominis larva and at 5, 10, 15, 30 and 60 days post-larval emergence (dple). Cell proliferation in vitro assays were carried out with RPMI-1640 medium and larval secretory product (LSP) of D. hominis at 5, 10, 15, 20 and 25 days. When each group of mice was tested against each medium, significance was only seen for 25 dpi, with increasing order: LSP-10 d, -25 d, -5 d, -20 d, -15 d and RPMI. Significant results were also observed when each medium was tested against mice at each dpi or dple. Each dple group vs. each medium produced significant results only for 10 dple, with increasing order: LSP-5 d, -20 d, -25 d, -10 d, -15 d and RPMI. Comparative tests were also carried out between groups to refine certain observations. The LSPs were also analyzed using SDS-PAGE. The results prove that myiasis caused depletion of spleen cells, particularly under the effect of the LSP-10 and -15, but the cells tended to increase up to 60 dple. This in vitro assay may represent the real systemic immune response in the relationship LSP-D. hominis-host.

Avaliação da segurança do teste de caminhada dos 6 minutos em pacientes no pré-transplante cardíaco

FUNDAMENTO: O teste de caminhada dos 6 minutos (TC6) tem sido utilizado como forma de avaliação da capacidade funcional, estadiamento clínico e prognóstico cardiovascular. A segurança e o impacto metabólico são pouco descritos na literatura, principalmente em pacientes com insuficiência cardíaca grave, com indicação clínica para transplante cardiovascular. OBJETIVO: Avaliar a ocorrência de arritmias e alterações cardiovasculares durante o TC6. Correlacionar o desempenho no TC6 com o estadiamento clínico e prognóstico cardiovascular. MÉTODOS: Doze pacientes, sendo 10 masculinos, com idade de 52 ± 8 anos, foram submetidos à avaliação inicial. Realizaram o TC6 com monitoramento eletrocardiográfico por telemetria, sinais vitais e lactato. Foram acompanhados por 12 meses. RESULTADOS: Os pacientes percorreram 399,4 ± 122,5 (D, m), atingindo um esforço percebido (EP) de 14,3 ± 1,5 e variação de 34% na freqüência cardíaca basal. Dois pacientes apresentaram arritmia de maior gravidade pré-TC6 e não pioraram ante o esforço, quatro tiveram elevação significativa nos níveis de lactato sangüíneo (>5 mmol/dl), e três interromperam o exame. A distância percorrida evidenciou correlação com a fração de ejeção (%) e classificação funcional (NYHA). Após 12 meses de seguimento, três pacientes foram a óbito, e reinternaram-se sete por descompensação cardíaca. A relação (D/EP) e freqüência cardíaca de recuperação no segundo minuto (FCR2, bpm) foram inferiores no grupo-óbito. CONCLUSÃO: O comportamento clínico e eletrocardiográfico sugere que o método é seguro, mas pode ser considerado de alta intensidade para alguns pacientes com insuficiência cardíaca grave. Variáveis relacionadas ao desempenho no TC6 podem estar associadas com a mortalidade no seguimento de um ano.

Herbicide selectivity in alfalfa crops

This study aimed to determine the selectivity of herbicides applied in pre- and post-emergence for alfalfa crops. Three separate experiments were carried out under greenhouse conditions. The first experiment was arranged in a completely randomized design with three replications in a 4 x 11 + 1 factorial scheme , with eleven herbicides (bentazon, chlorimuron-ethyl, fomesafen, fluazifop-p-butyl, saflufenacil, imazethapyr, clethodim, nicosulfuron, imazaquin, haloxyfop-methyl and MSMA), four doses of each herbicide (0.5 D, 0.75 D, 1.0 D and 1.25 D, where D = recommended dose), plus an untreated control. The products were applied to alfalfa plants at the stage of 4 to 5 leaf pairs. In the second experiment, the effect of pre-emergent herbicides on early alfalfa development was observed through a completely randomized design with five replications in a 3 x 4 x 2 factorial scheme, with three herbicides (hexazinone, atrazine + simazine, S-metolachlor), four doses (0.5 D, 0.75 D, 1.0 D and 1.25 D), and two types of soil texture (loamy and clay soil), plus an untreated control. The third experiment evaluated the action of atrazine, 2,550 g ha-1; clomazone - 600 g ha-1; diclosulam - 25 g ha-1; diuron+hexazinone - 936 + 264 g ha-1 and diuron+hexazinone +sulfometuron - 1,386 + 391 + 33.35 g ha-1 on alfalfa sown at different times after herbicide application. The effects of the treatments on alfalfa were evaluated according to visual phytotoxicity symptoms, plant height, and biomass of roots and shoots. Among the herbicides applied at post-emergence, imazethapyr, clethodim, haloxyfop-p-methyl and MSMA were selective for alfalfa, while among those applied at pre-emergence, none were selective, regardless of soil texture. The results of the third experiment showed that the herbicides diclosulam, hexazinone + diuron and atrazine caused less toxicity in alfalfa plants.

Exploring Herbicidal Potential of Aqueous Extracts of Some Herbaceous Plants Against Parthenium Weed

To assess the phytotoxic potential of Achyranthes aspera, Alternanthera philoxeroides, Datura metel and Rumex dentatus against Parthenium hysterophorus, 5% (w/v on dry weight basis) aqueous extracts from root, stem, leaf, flower and whole plant were tested through a Petri plate-based germination and pot-cultured seedling bioassays. Achyranthes aspera and A. philoxeroides inhibited parthenium weed germination more than extracts from other species. Whole plant, leaf and fruit extracts of A. aspera reduced the germination percentage (5%); leaf extract from A. philoxeroides caused lower germination index (0.4), higher mean germination time (14 d) and longer time to 50% germination (13.5 d) of parthenium weed. In the foliar spray bioassay, A. aspera reduced parthenium weed shoot growth more than the other species whereas R. dentatus caused more reduction in root growth. Whole plant extract from A. aspera caused maximum reduction in parthenium weed seedling vigor index (98%) and seedling biomass (96%). The aqueous extracts of A. aspera and A. philoxeroides contained higher concentrations of phenolics viz. gallic (16.9 mg L-1), caffeic (7.4 mg L-1), chromatotropic (63.8 mg L-1), p-coumaric (10.5 mg L-1), m-coumaric (3.1 mg L-1), syringic (9.21 mg L-1) and 4 hydroxy-3-methoxy benzoic (118.6 mg L-1) acids compared with extracts of the other two species tested.

Measuring higher order optical aberrations of the human eye: techniques and applications

In the present paper we discuss the development of "wave-front", an instrument for determining the lower and higher optical aberrations of the human eye. We also discuss the advantages that such instrumentation and techniques might bring to the ophthalmology professional of the 21st century. By shining a small light spot on the retina of subjects and observing the light that is reflected back from within the eye, we are able to quantitatively determine the amount of lower order aberrations (astigmatism, myopia, hyperopia) and higher order aberrations (coma, spherical aberration, etc.). We have measured artificial eyes with calibrated ametropia ranging from +5 to -5 D, with and without 2 D astigmatism with axis at 45º and 90º. We used a device known as the Hartmann-Shack (HS) sensor, originally developed for measuring the optical aberrations of optical instruments and general refracting surfaces in astronomical telescopes. The HS sensor sends information to a computer software for decomposition of wave-front aberrations into a set of Zernike polynomials. These polynomials have special mathematical properties and are more suitable in this case than the traditional Seidel polynomials. We have demonstrated that this technique is more precise than conventional autorefraction, with a root mean square error (RMSE) of less than 0.1 µm for a 4-mm diameter pupil. In terms of dioptric power this represents an RMSE error of less than 0.04 D and 5º for the axis. This precision is sufficient for customized corneal ablations, among other applications.